How family history of premature myocardial infarction affects patients at cardiovascular risk.

OBJECTIVE: Family history of premature myocardial infarction (FH-MI) increases the risk for coronary heart disease (CHD). Research has shown that this effect cannot be accounted for by increased genetic vulnerability alone. We tested the hypothesis that FH-MI is associated with psychological distress, which is known to increase CHD risk, and that this effect is sustained over years and mediated by personality traits and coping strategies. METHOD: Levels of distress (i.e., exhaustion, depression, and anxiety) were compared between patients with versus without FH-MI and those with versus without own history of myocardial infarction (MI) from the large observational Diagnostic trial on Prevalence and Clinical Course of Diastolic Dysfunction and Heart Failure (DIAST-CHF) study of patients with cardiovascular risk factors or manifest heart disease (N = 1,470). RESULTS: FH-MI was associated with a range of personality traits and coping strategies and independently predicted psychological distress, whereas own MI did not. In mediation analysis, we found that sociotropy and avoidant coping serially mediated significant portions of the effect of FH-MI on distress. Proportions of explained variance ranged from R2 = .11 for depressive symptoms to R2 = .25 for anxiety. Effects remained stable at 1-year follow-up. Several alternative hypotheses were tested and found to be less well supported by the data. CONCLUSIONS: Participants with cardiovascular risk factors and FH-MI report increased distress, even years after the event, which might be one component leading to their increased CHD risk. They should be offered support for dealing with distress and life events recurring on sociotropy and avoidant coping as important diathesis factors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).